The authors observe that, historically, health service boards focussed on financial issues and executive performance. Quality of care was assumed, poorly measured and its oversight was left to clinical leaders.

The authors highlight the importance of this new research as follows:

Our survey of all public health service Boards in Victoria found that, overall, boards are engaged in an impressive range of clinical governance activities. However, tensions are evident. First, whereas some boards are strongly engaged in clinical governance, others report relatively little activity. Second, despite 8 in 10 members rating quality as a top board priority, few members regarded boards as influential players in determining it. Third, although membersregarded their boards as having strong expertise in quality, there were signs of knowledge limitations, including: near consensus that (additional) training would be useful; unfamiliarity with key national quality documents; and overly optimistic beliefs about quality performance.